Minimally conscious state （MCS） is at the edge between closed and open consciousness， but it still belongs to the category of "wind-strike block" syndrome. The basic pathogenesis of MCS is the obstruction of pathogenic qi， orifices closed and spirit hidden， with pathological factors including phlegm， fire， and blood stasis. Wind movement and water retention may also be present， and often leading to deficiency syndrome due to the exhaustion of qi， blood， yin， and yang at later stages. Treatment chooses Shexiang （Moschus） as the chief medicinal， emphasizing combination of medicinals and urgency of medication administration； the key therapeutic method is to open the orifices， with focuses on expelling pathogens and reinforcing healthy qi. For patients with severe phlegm or fire， use Xiaochengqi Decoction （小承气汤） to open the lower orifices， discharge heat and unblock the bowels， combined with Shexiang （Moschus） and Niuhuang （Bovis Calculus） to open the upper orifices， awaken the spirit and guide qi. For patients with turbid phlegm as the predominant， temporarily replace Shexiang （Moschus） with Baizhi （Angelicae dahuricae radix）， using Ditan Decoction （涤痰汤） to eliminate phlegm to open the orifices， when turbid phlegm gradually subsided， Shexiang （Moschus） could be added. For patients with blood stasis as the predominant， Tongqiao Huoxue Decoction （通窍活血汤） will be used to activate blood and open orifice， if the blood circulates， the endogenous wind will be calmed， the water will be induced， the orifices will open and the consciousness will restore. For patients with closed orifices and body deficiency， the treatment should open the orifices and reinforce healthy qi， and consider the root and branch simultaneously； qi deficiency syndrome can be addressed with Buyang Huanwu Decoction （补阳还五汤） to boost qi and reinforce healthy qi； yin deficiency syndrome can be treated with Shaoyao Gancao Decoction （芍药甘草汤） combined with Fengsui Pill （封髓丹） to nourish yin， soften sinews， and secure kidney essence； yang deficiency can be managed by using Dihuang Yinzi Decoction （地黄饮子） to enrich yin， supplement yang， and open the orifices.

Alzheimer's disease （AD） is a chronic neurodegenerative disorder characterized by the progressive loss of cognitive and memory functions. Its pathological features mainly include neurofibrillary tangles formed by the aggregation of hyperphosphorylated tau proteins and amyloid plaques formed by the accumulation of β-amyloid. The exact pathogenesis of AD has not been fully elucidated， and there are currently no effective specific drugs or radical treatments available in clinical practice. In recent years， the incidence of AD has been on the rise， severely affecting life and health， making the search for effective drugs and therapeutic components for AD treatment crucial. Modern medical research has found that the brain-derived neurotrophic factor （BDNF）/tropomyosin receptor kinase B （TrkB） signaling pathway is closely related to neurogenesis， apoptosis， neuroinflammation， synaptic plasticity， and oxidative stress， playing a vital role in the pathophysiological development of AD. Additionally， Chinese medicine has a long history of treating neurodegenerative diseases with few adverse reactions and features a multi-target， multi-link， and multi-pathway approach to treatment. Therefore， the author reviewed the latest research reports in China and abroad to elaborate on the role of the BDNF/TrkB signaling pathway in the onset and progression of AD， and summarized the research progress on the regulation of the BDNF/TrkB pathway by Chinese medicine compounds and monomers in AD intervention. This study is expected to provide references for the development of clinical drugs for the prevention and treatment of AD and to broaden the perspective on Chinese medicine treatment of AD.

It is regarded that the general qi is the combination of spleen-kidney qi and heart-lung yang qi in the chest， which is filled between the muscles and is able to maintain the normal shape of the muscles. Accordingly， it is proposed that the core pathogenesis of amyotrophic lateral sclerosis （ALS） is the deficiency sinking of general qi， with "deficiency" as the root， and "toxin" and "wind-heat" as the key factors for the rapid progression of the disease. The development process of ALS was classified into the initial onset stage， the increasingly progressive stage， and the rapid exacerbation stage， and differentiated and treated by deficiency， toxin， and wind-heat. Based on clinical experience， the wind medicinals were preferred. We formed self-prescribed Juxian Decoction （举陷汤） and modified from the perspective of "deficiency， toxicity， wind-heat" based on the wind medicinals of Huangqi （Radix Astragali）， Shengma （Actaea cimicifuga L.）， Chaihu （Bupleurum spp.） and so on. For the initial onset stage， Yiqi Shengji Juxian Decoction （益气生肌举陷汤）， Wenyang Liyan Juxian Decoction （温阳利咽举陷汤） could be used； for the increasingly progressive stage， Jiedu Juxian Decoction （解毒举陷汤） could be used； for the rapid exacerbation stage， Yinqiao Shufen Juxian Decoction （银翘疏风举陷汤）， Yangxue Xifeng Juxian Decoction （养血熄风举陷汤） could be used.

Post-stroke depression is a common complication after a stroke. Based on the theory of ＂deficiency of heart qi leading to sadness＂recorded in Huangdi Neijing, our team proposes that deficiency of heart qi is the basic pathogenesis of post-stroke depression, with sadness being its main manifestation. Therefore, we advocate treating post-stroke depression from the perspective of the heart, and clinically, it can be divided into four stages: heart-liver stage, heart-lung stage, heart-spleen stage, and heart-kidney stage. Treating post-stroke depression with the principle of regulating qi and nourishing the heart, patients in the heart-liver and heart-lung stages are mainly middle-aged and young adults, with a pathological nature of qi stagnation and mild deficiency of heart qi, and therefore, the method of promoting the flow of meridians and regulating qi should be adopted. In contrast, patients in the heart-spleen and heart-kidney stages are mainly middle-aged and elderly, with a pathological nature of qi deficiency and severe deficiency of heart qi, and therefore, nourishment and tonification should be prioritized. In response to the above four stages, our team has achieved good clinical efficacy by administering Xiaoyao Powder, Baihe Dihuang Decoction, Ganmai Dazao Decoction and Jingui Shenqi Pill respectively. This study discusses the approach to treating post-stroke depression from the perspective of a "deficiency of heart qi leading to sadness" by examining three aspects: the theoretical basis of Chinese and Western medicine to treat post-stroke depression from the heart, the basic pathogenesis and staging of post-stroke depression, and the treatment principle of regulating qi and nourishing the heart. The study also briefly analyzes the clinical experience of the medications used for this condition to provide a reference for the treatment of post-stroke depression.

Chaihu Guizhi Decoction is an excellent prescription of ZHANG Zhongjing;however,nowadays the application of Chaihu Guizhi Decoction is primarily derived from the text.The xiang thinking is the source of traditional Chinese medicine thinking.Understanding Chaihu Guizhi Decoction from the xiang thinking,it is easy to perceive the true meaning of ZHANG Zhongjing,and grasp the location of the disease and the patient's overall qi,so as to make better use of this formula.This article discusses the understanding of Chaihu Guizhi Decoction from five perspectives:firstly,it gives an overview of the xiang thinking,pointing out the source and essential value of the xiang thinking;secondly,it analyses the disease position and the patient's qi of Chaihu Guizhi Decoction under the perspective of the xiang thinking as a whole;thirdly,it discusses the disease position and the patient's qi of the original text of Chaihu Guizhi Decoction from the xiang thinking;fourthly,it discusses how to understand the principle of formula formation and the main and minor parts of Chaihu Guizhi Decoction by xiang thinking;finally,it analyses the primary medicines in Chaihu Guizhi Decoction by using xiang thinking based on the records of Shennong Bencao Jing.Based on these five points,we hope to reveal the traditional Chinese medicine thinking behind Chaihu Guizhi Decoction,and provide new ideas for the clinical application of Chaihu Guizhi Decoction.

This article summarizes the unique viewpoints and experience application of the famous and veteran Chinese medicine practitioner,Professor Wang Xinzhi,in treating emotional diseases from the perspective of gallbladder theory.Based on the physiologi-cal functions and characteristics of the gallbladder in Chinese medicine,it is proposed that the"heart mind-gallbladder-viscera"axis dominates the generation and changes of emotions,and it is believed that gallbladder failure is the key pathogenesis of emotional disor-ders.The treatment of clinical syndromes should be based on the type of gallbladder,and emotional diseases can be divided into types of insufficient gallbladder qi,unfavorable Shaoyang,gallbladder and heat excess,timidity-deficiency,and heart-gallbladder indeci-sion,according to clinical manifestations;based on the basic principle of adjusting the functions of the heart,spleen,liver,gallblad-der,kidney and other organs,treatment methods such as tonifying the spleen and kidneys,increasing gallbladder qi,resolving Shaoy-ang,clearing gallbladder heat,warming yang and replenishing qi,calming the mind,resolving phlegm and removing blood stasis should be used,highlighting the joint treatment of the heart and the gallbladder,and the simultaneous regulation of the liver and gall-bladder,so that the mind can be at ease,the gallbladder can be decisive,and the emotions can be harmonious.

Objective To evaluate postoperative efficacy and safety of oral or nasal feeding Chinese patent medicine in the treatment of intracerebral haemorrhage(ICH)based on Bayesian network meta-analysis(BNMA).Methods The randomized controlled trial(RCT)study of Chinese patent medicine for intervening in post-operative patients of ICH was retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed,Embase,Cochrane Library,and Web of Science.The retrieval time is from the establishment of databases to August 25,2023.ROB 2.0 was used for risk of bias assessments.BNMA was performed by using R 4.2.2 loaded with the BUGSnet 1.1.0 package.Results A total of 28 RCTs were included,with a total sample size of 2 530 cases,including 9 kinds of Chinese patent medicines[Angong Niuhuang Pills(AGNH),Suhexiang Pills(SHX),Naoxueshu Oral Liquid(NXS),Naoxintong Capsules(NXT),Naoxuekang Tablets(NXK),Xiaoyukang Capsules(XYK),Yangxue Qingnao Granules(YXQN),Tongtian Oral Liquid(TT),Sanqi Tongshu Capsules(SQTS)].All patients underwent surgical treatment and postoperative treatment of conventional western medicine(CWMT),the experimental group was additionally given Chinese patent medicine orally or by nasal feeding.The BNMA results showed that AGNH+CWMT group ranked first in reducing short-term mortality,NIHSS score,and perihematomal edema,with P＜0.05 compared to CWMT group.SHX+CWMT group ranked first in improving total effective efficiency,with P＜0.05 compared to CWMT group.TT+CWMT group ranked first in increasing GCS scores,with P＜0.05 compared to CWMT group.YXQN+CWMT group ranked first in improving BI index,with P＜0.05 compared to CWMT group.NXS+CWMT group ranked first in promoting the absorption of cerebral hematoma,with P＞0.05 compared to CWMT group.NXT+CWMT group ranked first in shortening the average length of hospital stay,with P＞0.05 compared to CWMT group.Conclusion Compared with CWMT group,the combined use of Chinese patent medicine and CWMT is effective in improving the total effective rate,reducing mortality and NIHSS score,increasing GCS score and BI after operation in patients with ICH.There is no significant difference in promoting hematoma absorption and shortening the average length of hospital stay.AGNH has good effect,which may be the best Chinese patent medicine in the post-operative treatment of ICH patients.However,due to limitations in quality and methodology of included research,the conclusions obtained still need further validation.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective:To investigate the effectiveness and safety of the VA regimen, which combines venetoclax with azacitidine in the treatment of patients with newly diagnosed acute myeloid leukemia (AML) who are not suitable candidates for conventional chemotherapy.Methods:In the Department of Hematology at the Second Hospital of Hebei Medical University, 66 AML patients who received venetoclax and azacitidine treatment from May 2020 to March 2022 were the subject of a retrospective study. The complete remission (CR) rate, cCR rate, ORR rate, MRD negative rate, the incidence of adverse events,1-year EFS, and OS were retrospectively analyzed. Patients subgroups with varying ages, ECOG scores, primary and secondary, risk stratifications, and gene mutation were compared for differences in efficacy and survival.Results:The median follow-up was 4.25 (0.9-19.9) months, and the median number of treatment courses was 2 (1–8) cycles. After the first cycle, the cCR rate was 78.8% , and the MRD negative rate was 51.9% . After prolonged treatment, the cCR rate was 81.8% and MRD negative rate was 66.7% . The median EFS and OS, respectively, were13.2 and 15.3 months. Secondary AML showed inferior efficacy and prognosis. IDH1/2 or NPM1 mutation groups had a significantly higher rate of CR than the control group ( P<0.05) . The CR rate and MRD negative rate of patients with rebound thrombocytosis were significantly higher than those without rebound thrombocytosis ( P<0.05) . Those who had epigenetic modification mutations (DNMT3, ASXL1, TET2) were more likely to benefit from ongoing therapy. The most common grade 3 and 4 adverse reactions were neutropenia, thrombocytopenia, and anemia. Conclusions:In real-world patients with newly diagnosed AML who are not candidates for standard chemotherapy, the VA regimen produces rapid deep remission. Primary AML patients, rebound thrombocytosis, IDH1/2, and NPM1 gene mutations are favorable factors for treatment benefit, and adverse reactions were tolerable.

Objective:To investigate the difference of curative effect between zero-profile bridge-shaped locking cage (ROI-C) and anterior cage combined with titanium plate fixation in the treatment of two-level and three-level cervical spondylotic myelopathy.Methods:A total of 85 patients (43 males and 42 females), aged 52.3±8.0 years (range from 28 to 66 years) with bi- and three-level cervical spondylotic myelopathy who received surgical treatment from June 2017 to October 2019 were retrospectively analyzed. There were 63 cases of two levels and 22 cases of three levels. 45 cases were treated with zero-profile bridge-shaped locking cage ROI-C (ROI-C group), and 40 cases with anterior cage combined with titanium plate fixation (titanium plate group). The main observation indicators include operation time, intraoperative blood loss, cervical Cobb angle, fusion segment Cobb angle, average intervertebral height, pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) Score and neck disability index (NDI).Results:All of 85 patients were followed up for 16.9±2.0 months (range 12 to 22 months). The operation time of two-level ROI-C group was 110.37±8.25 min, which was shorter than 139.5±10.54 min of titanium plate group; the intraoperative blood loss was 15.74±8.10 ml, which was less than 23.71±9.70 ml of titanium plate group; the operation time of three-level ROI-C group was 130.00±5.70 min, which was shorter than 162.83±5.59 min of titanium plate group, while the difference in the intraoperative blood loss between the two groups had no statistical significance. One year after operation, Cobb angle of cervical vertebra in double and three-level ROI-C groups were 15.31°±1.55° and 15.20°±0.42°, respectively, which were largerthan 11.23°±2.03° and 9.20°±1.14° before operation; in titanium plate group, they were 15.89°±1.13° and 16.08°±1.88°, which were higher than 11.25°±2.01° and 9.00°±1.60° before operation, and the differences had statistical significance. The differences between the two groups before operation and 1 year after operation had no statistical significance. One year after operation, the VAS scores of double and three-level ROI-C groups were 1.83±0.66 points and 2.60±0.52 points, respectively, which were less than the preoperative 7.49±0.51 points and 7.60±0.52 points; the titanium plate group was 1.79±0.50 points and 2.41±0.51 points, which were less than the preoperative 7.61±0.63 points and 7.42±0.52 points, and the differences had statistical significance. There was no significant difference between the two groups before operation and 1 year after operation. One year after operation, the JOA scores of double and three-level ROI-C groups were 15.00±0.84 points and 14.70±0.95 points, respectively, which were higher than the preoperative 7.20±0.87 points and 6.60±1.27 points; the scores of titanium plate group were 15.29±0.85 points and 14.83±0.58 points, which were higher than the preoperative 6.89±1.03 points and 6.92±0.67 points, and the differences had statistical significance. The differences between the two groups had no statistical significance. The postoperative JOA improvement rate was excellent. Postoperative dysphagia occurred in 1 case (2.22%, 1/45) in ROI-C group and 8 cases (20.00%, 8/40) in titanium plate group, and the difference in the incidence rate between two groups had statistical significance ( χ2=5.32, P=0.02). Conclusion:Both ROI-C and anterior cage combined with titanium plate fixation in the treatment of double and three-level cervical spondylotic myelopathy can achieve good short-term clinical efficacy, with shorter operation time and lower incidence rate of postoperative dysphagia using ROI-C.